Demonstration of the DSMO website and progress reporting for the DSMO HIPAA change process.

1. How has the overall DSMO change process been working (or not working) i.e., early examples of requests to date, how they were processed, who handled them, etc.?

The initial batch of DSMO requests processed in December 2000 did not impact HL7. The second batch of DSMO requests, processed in January 2001, includes requests for the development of claims attachments. As such, HL7 will be participating in the development of a recommendation to satisfy the requests. This process was addressed at the January HL7 meeting and initial steps have been taken to begin this work.

2. How has the DSMO process impacted your organizational relationships with other SDOs as it relates to HIPAA implementation?

This process has served to increase the opportunities HL7 has had to interact with the other DSMO's. The development of this process has lead the DSMO organizations to become involved in one another's specific industry related efforts, to further open the lines of communication, and to provide support for one another with respect to activities related to the DSMO as well as those that aren't.

3. How has the DSMO process changed your organization's internal request process i.e., what internal process has been added or modified to address HIPAA implementation issues?

Within HL7 we had already begun to develop an internal change request process to accommodate those who approached us with attachment development needs. As we entered into discussions related to the MOU and the DSMO process began to take shape, we examined the process already in development and made all necessary modifications. One significant consideration was to create a process that supported the time frames established for developing recommendations in accordance with the MOU. Because our process is fairly detailed we have elected to provide you with the documented workflow and descriptions in lieu of explaining all steps in that process here. Key factors for success include tremendous support from HL7 head quarters as it relates to building databases and web-enabled solutions to facilitate communication, establishing list serves, hosting conference calls, as well as administrative support for any manual processes.

As has been our experience from the beginning, the HL7 Board of Directors and Technical Steering Committee have been actively involved in this process. The HL7 membership has also been kept current on DSMO related activities and encouraged to participate. In addition, a detailed explanation of the DSMO process has been incorporated into a tutorial that is delivered at each HL7 meeting.

4. What impact has the Errata Work Group (in X12) had to date on DSMO process?

To date, the impact appears to be that there may be confusion in the industry as to what is an appropriate entry for the errata website versus an appropriate entry for the DSMO web site. The confusion comes in primarily with the distinction that the errata effort was strictly aimed at addressing the X12 004010 version of implementation guides and the DSMO process addresses changes to future versions of these guides.

As the errata process moves forward and decisions are made regarding entries on that website, the result could lead to those entries being forwarded to the DSMOs in the form of change requests. This still remains to be seen.

5. What recommendations do you have to improve the DSMO process?

· Improved education at the industry level of the DSMO process. This could include HHS incorporating information about the DSMO process on the Administrative Simplification website and including discussion of it when presenting general "HIPAA" information at industry events. HL7 has already educated its membership (discussed in #3 above) as well as by issuing a press release and including DSMO information in the HL7 newsletter.

· Continue to improve communication between government and the DSMO Committees (e.g. HIPAA - related efforts underway within HHS that might affect work in progress either with regard to the DSMO process, or in the respective member organizations).

· Funding for the DSMO web site is needed if we are to make it a robust, full functionality website. Each DSMO member has already provided $ 5000.00 toward the development of the site, and all agree that there should be government funding to improve and keep the site operational.

· Funding could also be used to accomplish the educational effort recommended above. If members of the DSMO were able to educate the public on this topic at the appropriate venues, it would contribute to the successful and timely implementation of the standards. This is not achievable when the organizations that employ these volunteers are expected to absorb the cost for such activities.